Background: A substantial proportion of peripherally inserted central catheters (PICCs) are placed for inappropriate indications. We performed a multi-hospital intervention to improve the appropriateness of PICC use. Methods: We conducted a collaborative cohort study of hospitals participating in the Hospital Medicine Safety Consortium. An evidence-based intervention centered on the Michigan Appropriateness Guide for Intravenous Catheters [...]

Background: Since being introduced in the 1950s, midlines have since gained attention as an intravascular access option—particularly in patients requiring intravenous (IV) therapy for extended time periods. They provide an alternative to frequent venipuncture from peipheral intravenous catheters (PIV) and may reduce cost and increase patient satisfaction. The CDC and MAGIC guidelines currently recommend the [...]

Background: Peripherally inserted central catheter (PICC) use in patients with chronic kidney disease (CKD) is associated with non-functioning arteriovenous fistulae. Existing guidelines recommend avoiding PICC placement in these patients but how often this occurs and how best to implement this recommendation is not known. Methods: Within 42-hospitals participating in the Michigan Hospital Medicine Safety Consortium [...]

Background: Midline vascular catheters are gaining popularity in clinical practice. However, patterns of use and outcomes related to these devices are not well known. Methods: Trained abstractors collected detailed patient-, device- and outcome data from medical records of hospitalized patients that received midline catheters from 12 hospitals participating in the Michigan Hospital Medicine Safety (HMS) [...]

Background: Midlines are peripheral vascular devices inserted in the veins of the upper extremity with the tip located at or below the axillary vein. Complications associated with peripherally inserted central catheter (PICC) along with documented overuse has led to emerging interest and increasing use of midlines. However, whether midlines are safer than PICCs is not [...]

Background: Vascular access devices (VADs) play an integral role in the treatment of patients, since they can be utilized for the administration of intravenous medications (including antibiotics and chemotherapy), and often on a long term basis. A peripherally inserted central catheter (PICC) is a type of VAD, which is frequently utilized in different populations. Once [...]

Background: Peripherally inserted central catheters (PICCs) are an increasingly common vascular access device, with more than 4000 devices placed per year at our institution. Though these devices are generally considered safe and effective, they are not without risks, particularly of catheter-related infection and thrombosis. These risks increase exponentially with increasing number of lumens. At our [...]

Background: Peripherally inserted central catheters (PICCs) are often used as devices to extend intravenous treatment for hospitalized patients in post-acute settings. Variation between hospitals, indications for use, device characteristics, and outcomes for patients who receive PICCs and are discharged to skilled nursing facilities (SNFs) is not well known. Methods: Trained abstractors used a standardized approach [...]